Monday, January 30, 2006

throwing in the towel

i am giving up on breastfeeding. things have just gotten worse for a variety of reasons and now it's ridiculous - i am compromising my own sanity etc. i reached the end of my rope. i mean i had to get rx angina meds to manage the pain because i have raynauds of the nipple, now i have a candida infection in the same location, i have had clogged ducts three times, and the flow is so fast on one side that even if i have a perfect latch, rebecca will use her tongue to squash things because she is choking on the milk so the only way to feed her on that side is to have her sitting up so i have to support her head and body and hold up my size EE boob. i know that with practice patience and time i could make it work but i am making myself miserable in the process. i feel it has become an unhealthy obsession and i am not enjoying my daughter fully as a result. i am afraid people will judge me, and i hate to fail at things, and most of all i was afraid rebecca would not love me as much, but it's irrational and i know it. i was living in fear of each feeding and the pain it engendered. i would have a big cry every two days and was not eating or sleeping right because i didn't have time.
i think i have done what is best but i still feel guilty.

Sunday, January 29, 2006

Pills pills pills

Multivitamin: once per day to ensure adequate nutrients
Ibuprofen: 1 every 4 hours for clogged duct (in combo with hot shower and compresses)
Nifedipine: once per day for Raynaud's
Grapefruit seed extract (citricidal): 6 per day (2 pills 3 times per day) for potential Candida infection on nipples
Gentian violet: once per day for possible Candida infection (I actually have to paint this on - so now I have bright purple nipples)

Thursday, January 26, 2006

Rebecca drowsy
Rebecca with personality
Rebecca winking
Rebecca being cute
Rebecca kissy lips
Rebecca smiling
Rebecca yawning

The 6 week post-partum checkup

Today I had my 6 week post-partum checkup: urine, blood, blood pressure, internal, and frank discussion. Happily, everything is great.
I had a pulled groin ligament since the delivery. According to my GP, the ligament loosening hormones of pregnancy persist for a few months after the birth of the baby. I could easily have injured the ligament during delivery. Strengthening my abdominal muscles should help. She recommended Pilates - so I am borrowing a Pilates tape to try at home.
My weight loss is considered very good. Thirty gone, twenty left.
Unfortunately for me, I already have my period back - despite the fact that I am breastfeeding. This is about as early as menstruation can resume. Sometimes breastfeeding women don't start their cycle for over a year. This also means resumption of taking the pill. Combination estrogen/progesterone contraceptives interfere with milk supply in breastfeeding mothers, so I have to get a prescription for progesterone-only pills (called Micronor). They are in "discreet" packaging (why?!?!), and therefore, the box looks like a package of nicorettes. The effectiveness of progesterone-only pills is 1% less than regular pills - but that still leaves things at virtually 99%, so I am not concerned.
I also obtained a prescription for Nifedipine to treat my Raynaud's phenomenon of the nipple. To explain: once I managed to have Rebecca virtually exclusively breastfeeding (and occasionally cup-feeding), I started to have pain. I attributed this to the pain of less-than perfect latching and her occasional chomping. I thought the degree of pain I was experiencing was normal. Then it got to be that I was taking tylenol or ibuprofen every day. I still thought this was normal. Then Rebecca's initial latch on would be so painful that I would cry and break out in a sweat. At the same time, I needed the room to be sweltering because the cold was excruciating for me. I still thought it was my technique. I didn't even wear a shirt in the house anymore because I couldn't bear the touch of the fabric, and every time I picked Rebecca up, I had to be careful that I placed her dead centre on my chest. I was getting truly despairing. It was hard to imagine that she would learn and that things would improve. I had remarked that after feedings, the nipple would turn white, then purple then bright red. Ultimately, I looked online. It was either Raynaud's or a yeast infection. Based on the symptoms, it seemed obvious it was Raynauds. On Wednesday I went to a breastfeeding clinic at my community health centre and a nurse concurred about the Raynauds. The treatment - Nifedipine is actually an angina drug - but is routinely used to treat the pain of Raynauds - a microvascular compression disorder (don't worry - not that common). Anyhow, I have only taken one pill so far, but I already notice a difference. I am free! If I hadn't been able to receive a treatment for the pain, it would have been time to give up on breastfeeding - but now, I can keep trying to perfect things. If only I had known how irregular my experience was. When the baby smacks and clicks at the breast, it is symptomatic of a less-than-perfect latch. Well - when I spoke to my Mom, she said that I was always a noisy feeder. So obviously, someone can breastfeed with a less-than-perfect latch and never experience torment. It was then that I realized I should have gone to the breastfeeding clinic weeks ago - it would have been obvious just from observing the other Moms that my experience was NOT normal. So... the moral of the story is - while you can have some pain during breastfeeding, suffering is not normal.
I had Rebecca weighed at the breastfeeding clinic and her new weight is 10lbs 6.5oz.!

Monday, January 23, 2006

The growth spurt at 6 weeks

Rebecca has displayed an insatiable appetite at around 2am for three days running (so far). What they say about the 6 week growth spurt is true!
Greg and I have also noticed that Rebecca's face has changed: her nose is getting longer at the bridge. We remarked on it independently, so I'm confident it is true. The end of her nose is still button-like, but I expect it will remain that way while breastfeeding continues - of course, it will never stay button-like given her genetic heritage.

Saturday, January 21, 2006


Friday, January 20, 2006

On breastfeeding

I was hesitant to write on this subject. I may have had a few qualms about scaring people with my labour story (which really isn't that terrible), but I definitely had misgivings about relating my challenges with breastfeeding. Why? Because I think most women expect some suffering during labour, whereas I know for my part I was completely ignorant of some of the trials of breastfeeding. Nipple blisters anyone? It is easy enough to get discouraged in the process, I don't want women to be afraid from the onset. It is useful to be aware that it is common to run into problems with breastfeeding, so that you don't feel like a "special" case. I will not describe all of the details of my experience, but suffice it to say that Rebecca and I have run the gamut of techniques and devices.
The bottom line is - if you are committed to breastfeeding, it can be done. The city has ample resources available for those who need support and guidance (it is really quite impressive). The La Leche League can also provide support. And finally, should you wish to pay- you can always get a lactation consultant.
The caveat it - it may take some time to achieve success. It took me six weeks. So, it is a question of your patience and will power. You may need to spend quality time with your punching bag. You may need to speak to other women (that certainly helps). If you decide it's not for you, there is no shame whatsoever in going the alternate route - no matter what anyone may tell you or say to you.
I gave Rebecca and I 6 weeks to master breastfeeding before I was willing to quit. I had decided that if we couldn't get our act together by that point, then I was just being a masochist.
However, I am happy to report that Rebecca and I have now mastered the challenging and unnatural art of breastfeeding. It's taken 6 weeks but we have finally "arrived" (I rewarded myself with leopard print nursingwear, to help maintain my positive attitude - you have to have a positive attitude if you are going to place sensitive body parts into the maw of the amazing snapping turtle). I have to say, the number one surprise about motherhood has been how difficult breastfeeding has been. It has been a journey fraught with frustration but things have finally come together. I had no idea how complicated and problematic it could be. It was a learning experience for the both of us - with a steep curve. Truth be told, there were many factors which contributed to the difficulty in learning - Rebecca being born prematurely, Rebecca being jaundiced, the fact that I had prior surgery which may have severed some nerves and ducts, the size of her mouth versus the size of my breasts etc etc etc.
In the course of learning to breastfeeding the following has become obvious to me:
1 - There are a multitude of opinions on how to best address a particular breastfeeding problem (this is overwhelming) and it is hard to know beforehand what will work best for your particular baby
2 - Sometimes the notion that feeding the baby (period full stop) is the top priority - as opposed to breastfeeding the baby - gets lost in the shuffle
3 - If you do run into difficulties, the emotional support of your spouse (or whomever) can make the difference between giving up and persevering
4 - If a woman was at risk of post-partum depression or even just baby blues, the pressure to master breastfeeding (if she was brainwashed to believe alternatives were unacceptable - and believe me, there is a great deal of brainwashing going on) would contribute to her unhappiness
Anyhow, success is not perfection, but I am pretty pleased.

Sunday, January 15, 2006

Happy thoughts

I would not want people to dwell solely on what might be considered the "negative" side of having a child (i.e. the details of labour etc.). It is a completely overwhelming and wonderful experience.
Greg and I love Rebecca so much. Sometimes we just sit and stare at her. The experience of having a child has certainly brought us closer together and now Rebecca (taking care of her, making her happy and spending time with her) is our mutual focus. If you have ever had a perfect day - when you are so happy that you feel as though your heart will burst - well, that is how we feel almost all the time. This is not to say that we don't get frustrated or stressed or anything like that - we certainly do - but, it only takes a few minutes with Rebecca to make us deliriously happy again.
This is a thought I shared with a friend in a recent email that explains some of my initial feelings:
"My Christmas was very different than I expected (naturally). I didn't even manage to decorate at home - but since I spent most of my time with my parents or Greg's parents, that didn't really matter. Greg tried to take a picture of Rebecca inside her Christmas stocking, but it didn't really work out. I have to say - to have a newborn at home during the holiday season was hectic in many ways, but it also gave me a different perspective on Christmas. Despite the fact that it is a celebration that focuses on the birth of a child - I had never truly considered it from a maternal angle before. The hopes and anticipations associated with the birth of a new baby are amazingly powerful, and the feeling that a tiny child can make a huge difference to the world, can make people smile, and can profoundly change the way you look at your life, are such a big part of things. Everything else - so many of my usual Christmas traditions, all the little things that usually are a fundamental part of Christmas for me - really became secondary, and I never for a minute felt like anything less than one of the luckiest people around."

Saturday, January 14, 2006

All about labour: Stages 2 and 3

Once again a warning - only read if you truly wish to hear labour details. Also, please bear in mind that every woman has a different experience.
When I was fully dilated, the nurse told me it was time to start pushing. Greg and Mom were instructed to hold my legs, which had to be bent such that my knees were drawn up towards my chest. I had to grab the back of my thighs and push when contractions started. I had to take a deep breath and hold it for about ten seconds while pushing, then exhale. I had to repeat the pushing and breath-holding two more times during the same contraction. Holding my breath was the hardest part. I could feel myself getting red in the face. I also gave a major workout to all the muscles in my shoulders, back and legs, which I felt for days to come. And a first for me - I managed to bruise the bottoms of my feet (there were eventually some wood supports for me to rest my feet against). The baby crowned very quickly, which prompted the appearance of various types of doctors, residents and nurses. Unfortunately, despite the progress, the baby kept slipping back in. Also, there was debate over which direction the head of the baby was pointing. Things were taking longer than expected, but neither the baby or myself were physiologically distressed. However, after two hours, the energy required to push was exhausting me and I started to fall asleep between contractions (at this stage contractions lasted a minute or two minutes, with thirty seconds to ninety second in between). I knew when contractions were started because at some point a little area on my body was no longer under the effect of the epidural and I could feel the pain. Eventually that was fixed (I guess the epidural was wearing off) but at one point it was truly excruciating. Anyhow, once it was apparent that my energy was waning and the baby was no further out, they began to discuss options to help get the baby out. This was a big relief - not only for myself but for Greg and Mom as well. Ultimately, they used a vaccum to help remove Rebecca. It looked like a toilet plunger. Before doing so, there was a great deal of poking and prodding going on - which thankfully, I did not feel. My biggest frustration was having a half dozen people telling me to push harder, when I was already pushing as hard as I could. It was at that moment that I wanted to kick people or yell at them - but somehow I refrained from doing so. On the final contraction they managed to pull Rebecca out. I could feel the pressure as she was removed and the enormous relief that labour was finished. The placenta came out immediately so stage 3 labour was quite short. Greg cut the cord and they placed Rebecca on my chest. She was covered in all manner of goo. I was sort of stunned, tired and overwhelmed. Then they weighed her. Both Greg and my Mom cried. I gave Greg a hug and as I took my hand away I noticed that I had left a bloody smear on his shirt (from the baby). Then, as Mom and Greg went over to look at Rebecca and take pictures, I watched the obstetrician stitch me up. I have such a clear memory of the curved needle going up and down for what seemed like forever. I couldn't feel anything though. I was told I had second degree lacerations and that the stitches were all internal. Second degree lacerations go through skin, mucosa and into muscles. It's worse than first degree lacerations which often require no stitching, but far better than third and fourth degree lacerations that cover a deeper and more extensive area.
In the end, I got to hold Rebecca -which was wonderful, and get a well-deserved sleep.

The dirt on diapers

What seems to shock most friends my age who do not have children, is the frequency of feedings and diaper changes. Maybe I should let them remain ignorant, because the truth is daunting. Yes, you really do kiss sleep goodbye for a long time - no exaggeration. Yes, feedings happen on average (at least, in the first few months), about every 3 hours. Of course, sometimes the baby cluster feeds and wants food on the hour. Fortunately, that is not the norm for Rebecca.
Now... let me delve into the controversial topic of diapers. In the first month, you can go through as many as 15 diapers in a day. No joke. That's a lot of diapers. You get to be an expert diaper-changer and you also become inured to being covered in poo, pee, vomit, spit and your own milk. At any rate, my Mom had me exclusively in cloth diapers because my sensitive skin could not tolerate the 1970s diaper materials. Well, things have changed. Before having Rebecca, I researched both options. Environmentally, there appeared to be no clear winner. While disposables took a long time to degrade, they were made of some natural materials. Cloth consumed a lot of energy for washing (and time). Cloth is more expensive, especially if you have a diaper service (which also means you buy diapers and get random ones back - not your own). I suppose you could wash them all yourself, but time is really at a premium (at least in the early days). I had been advised that if I opted for cloth, I might still want to have disposables for the night time.
At any rate, we are currently using disposables and I am quite happy. I think cloth for the daytime might eventually be something we do - when her number of bowel movements are considerably lessened. In that case, I would wash them myself. Right now, just getting on top of regular basic chores (eating, laundry, showers and baths, sleeping) is enough of a challenge.
At the beginning, babies have this gross tar-like and slightly green poo. This quickly becomes (in breast-fed babies), the liquidy yellow seedy poo - which remains until they start eating solids (at about 6 months) or until you introduce formula (which makes things more solid and brown). For the first 4 weeks, basically every diaper had poo and pee in it - you have to remember that the baby digestive system is tiny. Happily, we are now at the strange where there are only 2 or 3 major poos per day and most diapers are pee. It makes life a lot easier.
We have learned the hard lesson that there should always - without fail - be a diaper under the baby. Even so, sometimes Rebecca manages to bypass a diaper during a changing. The thing is - when you are cleaning the baby during a diaper change, the act of wiping their bum and other bits tends to stimulate them to pee or poo, so most major accidents happen during the change. On one particularly scary day during the Christmas holidays, Rebecca was being changed and managed to hit the wall, the floor, the hamper, the night table and Greg with a stream of yellow poo. I couldn't stop laughing (sleep deprivation), and Greg was rather nonplussed.
They say the first two weeks are hell - and they really are, but you have to learn not to lose your cool or get discouraged. It does get better.

Monday, January 9, 2006

Rebecca update

Just this past week, Rebecca had her 4 week checkup.
It's hard to believe she's been around that long! And as of today (Jan.14), she is five weeks old! Already, some of her clothes don't fit anymore, and we moved from newborn diapers to "phase 1" size diapers. Sometimes I wish we could keep her this small forever.
Her colour and reflexes are all excellent. She is now over 9lbs in weight and is apparently in the 75th percentile for weight. She is in the 90th percentile for length. Pretty good for a baby who was technically a premie!
As usual, I went to the checkup armed with a list of questions. Rebecca has red marks at the back of her neck which have been present since birth. Apparently these are birth marks which will eventually fade. My GP said it's quite common to have birthmarks in that locations and also just north of the butt.
Rebecca's right eye infection persists. Greg and I treat her with antiobiotic drops twice a day (fusithalmic). This infection is the result of a blocked tear duct (yet another common condition), which has been blocked since day 1. It doesn't cause her any pain, but gross yellow/green liquid oozes out of her eyes and coats the lashes. We must clean that eye a billion times a day. We massage in the duct area to encourage it to open. Hopefully opening will occur at some point. If it isn't opened by 10 months, babies undergo a surgical procedure to have it opened. According to my Mom, I had this condition in both eyes as a baby. I was booked for the surgical procedure when the ducts finally opened.
Rebecca also has baby acne which is another visually unappealing but harmless condition. It peaks at about 6 weeks then disappears. Basically, she gets zits on her face. Mind you, they endlessly migrate. There might be a bad patch in one particular location on one day, and then on the next day - that patch is clear and a new patch has appeared somewhere else.
Anyhow, next checkup is at 2 months, which is when she gets her first vaccinations. I was advised to purchase some baby tempra or baby tylenol to give her prior to the shot. Apparently the baby can be quite uncomfortable for about 24 hours. The baby tempra came in cherry and banana flavours. I chose banana because that is what I would want, but frankly - Rebecca doesn't know banana from cherry. It's like the textured bottoms on her socks and footed sleepers - a pointless feature at her age.

All about labour: Stage 1

If you are looking for updates on Rebecca, this is not the entry for you. There will be updates on Rebecca in future posts.
So... as promised, I will tell my labour story. This isn't one of those scary labour stories, so you don't have to worry about being turned off the notion of ever giving birth.
Anyhow, as you will be taught if you take a prenatal class, there are three stages to labour.
Stage 1 consists of the latent, active and transition phases. In stage 1, the cervix thins and dilates to the full 10cm.
Stage 2 consists of the pushing part and the delivery of the baby.
Stage 3 is the delivery of the placenta.
This particular blog entry is about the experience of stage 1.
My labour was technically pre-term labour and my baby was technically premature (a premie). Fortunately, Rebecca was "near term" and therefore she was not a whole lot different than a full term baby. In fact, her weight (7lbs 3 oz) was average for a full term baby. One shudders to think of how big she might have been had she arrived in January as originally anticipated.
As previously described, after my work Christmas party at the raceway, I went home, fell asleep and awoke in the wee hours of the morning to the breaking of the waters. I should point out that the vast majority of women don't break their water before they are well into labour (about 90% of women don't break their water before the onset of active labour, despite what mass media may have led you to believe). In fact, sometimes women have to have their water broken for them using something that looks like a crochet hook (but this is supposedly painless). At any rate, a word of advice for any women reading this blog who intend to have children in the future. Be ready early! And on the off chance that you break your water before your labour starts, make sure you have stocked up on pads - not the wimpy ass kind you might normally use, but the mega kind. They will also be of use post-delivery. And there is nothing like coming home from the hospital and having to wash amniotic fluid out of your clothing.
So, once my water had broken and my group B strep turned out to be negative, I was given the option of walking around the hopsital to see if my contractions would start, or going home. Since I live a two minute drive from the hospital, I elected to go home. Besides, we were tired. They told me I should rest. How was I supposed to rest when I was so excited? In retrospect, I should have. Instead, I watched videos with Greg, including the excellent "March of the penguins". In the late afternoon, I started having contractions. I had asked Greg for a new digital watch for Christmas, and he gave it to me early so that I could time my contractions. When they first started happening, I wasn't sure what they were. They were not regularly spaced and felt like menstrual cramps - a dull achey pain that came in waves. The reason I wasn't sure if they were was because i had been told the feeling would start as a wave from at the top of the uterus downwards. Instead, things would start in my lower back. As the day progressed, the pain became more intense and the intervals of time shorter. Sometimes the intervals were as short as three minutes, sometimes six minutes - things never became regular (even at the very end of delivery this was true for me). It got to the point where the pain made it impossible to concentrate on anything else. I dutifully practised my breathing exercises, but it didn't seem to help that much. I was uncomfortable enough that I decided to return to the hospital at midnight. It was almost 24 hours since my water broke anyhow - so they would want to induce me. Unfortunately, there were so many women in labour that particular night, that they wanted to wait a bit before inducing me. So Mom, Greg and I hung out in my delivery room and various nurses checked up on me at random intervals. At this point, I was in a great deal of pain and I was looking for some manner of relief. I was offered three choices: morphine, nitrenox, or epidural. What I really wanted was an epidural. Nitrenox can only be administered to a limited extent and limited number of times and I was not keen to have morphine at all. In order to administer an epidural, they had to check how dilated my cervix was. This is done by a nurse or resident using their fingers. You can imagine how much fun that is. Sometimes the process of checking the dilation results in further dilation. Anyhow, I am already a person who doesn't enjoy annuals and I was told my cervix was "far back". I found the dilation check so painful that I ended up taking nitrenox just so I could endure the pain. And ultimately, while it was a trippy and dissociative experience, it did little to alleviate my discomfort. And guess what - I was only 1cm dilated. In the end, they decided to induce me and then proceed with an epidural "early than usual" because they didn't think I could endure more dilation checks. That was fine by me. To insert the epidural, they stick a needle in your spine (technically in space around your spine). The area was frozen first but the procedure felt quite odd. I had to sit on the end of the bed and lean forward while it happened (despite enormous prego belly). I also had to let them know when contractions were coming and I had to avoid moving. Well, the first attempt gave me a jolt down a nerve and I jumped. They actually had to make several attempts before the needle was well positioned (it kept nicking something and making an uncomfortable sensation on my lower left side). Once the needle was in and the drugs added - it was like heaven. My lower body was numb and the pain was gone! I could sleep - thank God - I was already so tired (and Mom and Greg got to sleep too)! And I also found the will to be pleasant to my long-suffering labour coaches. Of course, I was now bed-bound and my blood pressure was regularly monitored. They also had to empty my bladder using a catheter, but frankly I didn't care anymore. I didn't feel pain and by that point, so many strangers had been glancing at me that I didn't even feel embarassed anymore. The oxytocin (inducing drug) was very effective, and soon I was dilated even more. Before I knew it, I was through the active phase and into the transition phase. By now it was morning of the next day. They wouldn't let me eat anything but ice chips (they didn't even want me to drink water). Mom had fed me a cheesestring at one point, but when I hit the transition phase (dilation of the last 3cm), I was hit with terrible nausea and a threw up twice (quite common at transition). I felt so much better after vomitting. It took almost no time for me to become fully dilated (10cm). It was time for the hardest part.

Thursday, January 5, 2006

What do I do all day?

From my recent records:
4:45PM feed
6:45 PM feed
9:45 PM feed
12:15AM feed
2:45AM feed
5:31AM feed
9:00 AM feed
12:00PM feed
1:30PM feed
3:50PM feed
5:15PM feed
6:40PM feed
8:40PM feed
11:15PM feed
1:35AM feed
3:06AM feed
5:50AM feed
8:30AM feed

And so on and so forth.

What does that feel like? It feels like one perpetual day - and that day started when I got home from the hospital. Really - it feels like a day that never ever ends because the time of day no longer matters for anything. In fact, it is often difficult for me to remember which day of the week it is.

Greg takes a hit for the team during the night, which allows to sleep for longer than one hour. The most consecutive hours of sleep I have had since I came home from the hospital is five hours, but that only happened once. Last night I had a stretch of sleep that was four hours long and it was spectacular.

Rebecca was weighed yesterday and has gained over a pound in the last week. Hooray! She now weighs over eight pounds.

Feeding is preceded by diaper change which can take about ten minutes if multiple diapers are involved, and if clothing needs to be changed, or if the wall and floor have to be cleaned.
A feeding can be as long as an hour.
After feeding the baby has to be burped and settle down. Sometimes this takes an entire hour.
Feeding is followed by dual pumping which takes 15 to 20 minutes plus 15 to 20 minutes for washing and sterilization.

The only reason I am posting to the blog right now is because Rebecca is in her Snugli with me - she wouldn't sleep without being against me. She has definitely trained me.

Gotta run, the clock is ticking.
The clock is always ticking.
I should point out that this is a clock for which - despite the harrowing schedule of tending to the needs of the newborn - I would never turn back the hands.